The biochemical, physiological, and clinical effects of cyclic guanosine 3′,5′-monophosphate specific phosphodiesterase (cGMP-specific PDE) inhibitors suggest their utility in a variety of disease states in which modulation of smooth muscle, renal, hemostatic, inflammatory, and/or endocrine function is desired. Type 5 cGMP-specific phosphodiesterase (PDE5) is the major cGMP hydrolyzing enzyme in vascular smooth muscle, and its expression in penile corpus cavernosum has been reported (A. Taher et al., J. Urol., 149, pp. 285A (1993)). Thus, PDE5 is an attractive target in the treatment of sexual dysfunction (K. J. Murray, DN&P 6(3), pp. 150–56 (1993)).
Daugan U.S. Pat. No. 5,859,006 discloses a class of β-carbolines, and pharmaceutical compositions thereof, which are useful in the treatment of conditions wherein inhibition of PDE5 is desired. Also, see PCT publication WO 97/03675 disclosing the use of such β-carbolines for the treatment of sexual dysfunction.
The poor solubility of many β-carbolines useful as PDE5 inhibitors has prompted the development of coprecipitate preparations, as disclosed in Butler U.S. Pat. No. 5,985,326. Briefly described, coprecipitates of β-carbolines with a polymer, e.g., hydroxypropyl methylcellulose phthalate, were prepared, then milled, mixed with excipients, and compressed into tablets for oral administration. However, studies revealed some difficulties in generating precisely reproducible lots of coprecipitate product, thereby making the use of coprecipitates less than ideal for pharmaceutical formulations.
In addition, clinical studies involving administration of tablets containing such a coprecipitate preliminarily revealed that maximum blood concentration of the β-carboline is achieved in 3 to 4 hours, with the average time for onset of a therapeutic effect as yet not precisely determined. When used for the treatment of sexual dysfunction, such as male erectile dysfunction or female arousal disorder, a more rapid attainment of maximum blood concentration, along with a greater prospect for rapid onset of therapeutic effect, is desired by patients, who prefer more immediate effects.
Accordingly, there is a continuing need in the art for oral dosage forms of β-carbolines, and pharmaceutical compositions thereof, useful in the treatment of conditions where inhibition of PDE5 is beneficial.